| NPI | 1356461875 |
|---|---|
| Former Name | MICHELLE CONSTANCE BERNARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 8398) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: IN 12011045A) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2019-10-01 |